Provider Demographics
NPI:1104237569
Name:SWAFFORD, LATASHA MARIE (NP)
Entity type:Individual
Prefix:
First Name:LATASHA
Middle Name:MARIE
Last Name:SWAFFORD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2610
Mailing Address - Country:US
Mailing Address - Phone:513-351-9900
Mailing Address - Fax:
Practice Address - Street 1:8780 US 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-6936
Practice Address - Country:US
Practice Address - Phone:859-384-8320
Practice Address - Fax:859-384-8338
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-19
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.15881-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily